building antimicrobial stewardship and engaging prescribers

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This presentation was delivered in session F1 of Quality Forum 2014 by: Victor Leung Infection Prevention & Control Physician Providence Health Care Clinical Assistant Professor, Pathology and Laboratory Medicine UBC

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  • 1. Building an antimicrobial stewardship program by engaging prescribers Dr. Victor Leung, MD FRCPC

2. SEX AND THE SUPERBUG The rise of drug-resistant gonorrhea. BY JEROME GROOPMAN 3. CONSEQUENCES OF INAPPROPRIATE ANTIBIOTIC USE 4. We have an opportunity to delay the postantibiotic era and optimize patient outcomes by improving antibiotic prescribing behavior 5. PROPHYLACTICEMPIRICPATHOGEGN DIRECTEDSUSCEPTIBILITY GUIDED 6. Systematic and coordinated approach to selecting antimicrobials to achieve optimal outcomesDiagnostic test utilizationData collection + analysisResearch Stewardship InfrastructureCollaboratio n with prescribersAcademic DetailingEducationOptimize Antimicrobial UseFormulary restrictions 7. PRIMARY DRIVERS OF INAPPROPRIATE ANTIMICROBIAL USE Indiscriminate laboratory testingKnowledge gaps Inappropriate Antimicrobial Use Inadequate documentation and transitions in careDiagnostic Uncertainty or Fear 8. Systematic and coordinated approach to using appropriate antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationStewardship InfrastructureOptimize Antimicrobial UseFormulary restrictions 9. Educational Journal Club Events Reached over 100 Prescribers 10. Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationStewardship InfrastructureOptimize Antimicrobial UseFormulary restrictions 11. Academic detailing offers point-of-care education Microbiologic data Local resistance patterns Evidence based guidelines Potential errors: Broad spectrum Dosing medication interactions allergies 12. Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationStewardship InfrastructureOptimize Antimicrobial UseFormulary restrictions 13. Urine Cultures from PHC Residential Care Facilities are Decreasing 300250Number of Urine Cutlures2002009 2010150 2011 20121002013 500 BFHFHYouville Residential Care FacilityLanagara 14. 21 15. Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationStewardship InfrastructureOptimize Antimicrobial UseFormulary restrictions 16. Year to Date (YTD) Antibiotic Expenditures $1,600,000 $1,400,000Actual Expenditures$1,200,000 $1,000,000 $800,000 $600,000Budgeted Expenditures$400,000 $200,000 $0 12345678Periods910111213 17. Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationOrganizational StructureOptimize Antimicrobial UseFormulary restrictions 18. Systematic and coordinated approach to using antimicrobial agents to achieve optimal outcomesDiagnostic test utilizationData collection + analysisCollaboration with prescribersAcademic DetailingEducationStewardship InfrastructureOptimize Antimicrobial UseFormulary restrictions 19. Call to action The next time you prescribe an antimicrobial or assess the need for an antimicrobial, ask yourself: What am I treating? How long should I treat? Is there an alternative, more appropriate antibiotic?bugs&drugs@providencehealth.bc.ca

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